Natriuretic hormones, endogenous ouabain, and related sodium transport inhibitors.

Natriuretic hormones, endogenous ouabain, and related sodium transport inhibitors.
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DOI:
10.3389/fendo.2014.00199
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发表时间:
2014
影响因子:
5.2
通讯作者:
Hamlyn JM
Hamlyn JM
中科院分区:
医学2区
文献类型:
--
作者:
Hamlyn JM

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DeWardener和他的同事的工作激发了人们对利钠激素(NHS)的长期兴趣。除心房肽(AP)外,循环中还含有生理上不明的NHS。一个NH由中枢神经系统(CNS)控制,很可能是由脑下垂体分泌的。它的循环活动受盐摄入量以及血液和脑室内液体中普遍存在的钠浓度的调节,并有助于餐后和脱水后的钠尿。另一种NH由心房牵张动员,通过增加肾内多巴胺和/或一氧化氮(NO)的产生来促进钠尿。这两种NHS的循环半衰期都很短(35 分钟),抑制了肾小管钠的转运,而且都不需要肾神经。对NHS的搜索导致了内源性强心类固醇(CTS)的出现,包括哇巴因、地高辛和蟾酥二烯内酯类物质。这些CTS以高纳米摩尔到微摩尔量的形式急性进入全身或肾脏循环,抑制钠泵,并具有利钠作用。在这些CTS中,只有蟾酥被足够快地清除,才有资格担任类似NH的角色。哇巴因样CTS被缓慢清除,当长期给予每天低纳摩尔量时,促进钠滞留,增强动脉肌源性张力,减少肾血流量和肾小球滤过,抑制肾直肠血管中的NO,并增加交感神经活动和血压。此外,降低全身钠会增加循环中的内源性哇巴因。因此,哇巴因类CTS具有与醛固酮一样的生理作用,支持肾钠滞留和血压。综上所述,哺乳动物的血液循环中含有两种非AP NHS。确定CNS NH应是优先事项。
The work of deWardener and colleagues stimulated longstanding interest in natriuretic hormones (NHs). In addition to the atrial peptides (APs), the circulation contains unidentified physiologically relevant NHs. One NH is controlled by the central nervous system (CNS) and likely secreted by the pituitary. Its circulating activity is modulated by salt intake and the prevailing sodium concentration of the blood and intracerebroventricular fluid, and contributes to postprandial and dehydration natriuresis. The other NH, mobilized by atrial stretch, promotes natriuresis by increasing the production of intrarenal dopamine and/or nitric oxide (NO). Both NHs have short (<35 min) circulating half lives, depress renotubular sodium transport, and neither requires the renal nerves. The search for NHs led to endogenous cardiotonic steroids (CTS) including ouabain-, digoxin-, and bufadienolide-like materials. These CTS, given acutely in high nanomole to micromole amounts into the general or renal circulations, inhibit sodium pumps and are natriuretic. Among these CTS, only bufalin is cleared sufficiently rapidly to qualify for an NH-like role. Ouabain-like CTS are cleared slowly, and when given chronically in low daily nanomole amounts, promote sodium retention, augment arterial myogenic tone, reduce renal blood flow and glomerular filtration, suppress NO in the renal vasa recta, and increase sympathetic nerve activity and blood pressure. Moreover, lowering total body sodium raises circulating endogenous ouabain. Thus, ouabain-like CTS have physiological actions that, like aldosterone, support renal sodium retention and blood pressure. In conclusion, the mammalian circulation contains two non-AP NHs. Identification of the CNS NH should be a priority.
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发表时间: 2009-03
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